Individual provider Active NPI

Samson Yang, D.M.D.

  • Dentist
  • San Diego, CA
National Provider Identifier
1972891760
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60510 Issued in CA
Practice address
5527 Clairemont Mesa Blvd
San Diego, CA 92117-2342
Phone
(858) 467-0503
Fax
(858) 467-9103
NPI assigned
Jul 14, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 60510 CA Primary

Addresses

Primary practice location

5527 Clairemont Mesa Blvd
San Diego, CA 92117-2342

Mailing address

5527 Clairemont Mesa Blvd
San Diego, CA 92117-2342
Phone (858) 467-0503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
60510CAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1972891760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5527 CLAIREMONT MESA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921172342",
            "telephone_number": "858-467-0503",
            "fax_number": "858-467-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5527 CLAIREMONT MESA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921172342",
            "telephone_number": "858-467-0503",
            "fax_number": "858-467-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "SAMSON",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-14",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "60510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.